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Do detox diet products work?

Tempted by detox-in-a-box?

Fad diets are nothing new, but there are concerns about the growing popularity of "detox" diets, juice diets and highly restrictive eating regimes.

In 2013, CHOICE reviewed 10 detox diet products available on pharmacy shelves to find out whether they really act as an "internal broom", or whether all of the sweeping claims are merely unfounded marketing spin.

With a wide range of detox products available at your local pharmacy, celebrity eating plans popping up on your social media feeds and new books on the topic appearing regularly, there's no doubt the business is a lucrative one. This year, Australians are predicted to spend $644 million on diet products and weight loss services.

There is little evidence detox diets actually remove toxins, according to accredited practising dietitian Melanie McGrice. She says this is a job your kidneys and liver do by themselves every day.

As a dietitian, McGrice regularly sees patients who come to her "hoping to find a remedy" after a particularly poor period of eating or drinking. The problem is, the punishment of a strict "detox" diet doesn't really make up for the binge.

"People have this idea of a detox diet as a way of dealing with their guilt about having a diet that previously contained sugars, fats and or alcohol, but two wrongs don't make a right," McGrice says. "It may alleviate your guilt but it is actually doing more harm than good."

Most detox products spruik some kind of cleansing benefit for the liver or kidneys. In some cases, products encourage severe restrictions of key food groups, such as meat and dairy. Worryingly, others recommend eliminating food altogether.

Accredited practising dietitian Kate Di Prima rejects the idea that you need a detox product to achieve a healthy liver. Liver cleansing doesn't actually have to be a complicated process at all, she says - all you need to do is avoid excessive amounts of alcohol, caffeine and saturated fats.

To personalise our investigation, CHOICE assigned the diet detox products to volunteers who agreed to trial the product and provide feedback.

Volunteers were instructed to follow the eating plan outlined in the product instructions and where this was not available, they were given a healthy eating plan similar to the one listed in this article.

Although some of our volunteers said they felt better at the end of the trial, all of them put this down to the healthy eating plan and elimination of added sugars and processed foods. None said they would be willing to pay for the products out of their own money. Here's a sample of what some of our volunteers had to say:

QuickTrim Fast Cleanse 48hr Super Diet Detox

How did you feel at the end of the detox?

"I felt pretty bad - slightly bloated, a bit headachey, probably as a result of the very limited diet this 'detox' prescribed.

"I have no idea what the ingredients in my detox drink were meant to do (I have been on other detoxes before that did make me feel different / possibly even better) but this one didn't do that."

Would you buy the product or recommend it?

"I was quite shocked that a bottle of lemon-flavoured liquid could cost as much as it did when it didn't seem to do anything. Would I pay for it? No way. It blows my mind that this product is being advertised so heavily on radio and - thanks to the visit by Kim Kardashian - has had so much publicity that I'm sure it will sell millions of units despite not working."

Lemon Detox

How did you feel at the end of the detox?

"It felt good to watch what you eat, but it didn't make me feel any better. I think I could achieve the same feeling of wellbeing and healthiness by just following a healthy eating plan."

Would you buy the product or recommend it?

"Definitely not - I would be very disappointed if I paid for the product as I could have bought the ingredients from the supermarket for a fraction of the cost. And as a result of the laxatives, I had to be near a bathroom for most of the day."

Blackmores Kickstart Detox

How did you feel at the end of the detox?

"During the detox I had headaches, felt sluggish and had very low energy levels. The headache didn't ease until day six! I ate very healthy and felt less bloated than usual (probably because I cut out carbs), but it wasn't worth it for the tiredness and nausea I experienced."

Would you buy the product or recommend it?

"No. It made me realise that you don't need to take a pill to feel better, you just need to plan mentally and give yourself a set period of time to eat healthy and make sure you stick to it."

Brauer 10 Day Detox

How did you feel at the end of the detox?

"I didn't notice any obvious results or improved wellbeing from taking the detox, except that I consciously drank more water as the detox liquid had to be consumed with two litres of water each day. The only positive effect may have been related to the fact that I was consciously monitoring my food intake throughout the day and had the 'feeling' that I was doing a good thing for my body - its greatest effect for me was as a motivational tool more than any other outcome."

Would you buy the product or recommend it?

"For no other feeling other than the satisfaction of having 'tried' to detox, the product is not good value. I think that keeping a food diary, maintaining a set healthy eating plan and exercising would bring the same, if not much more, benefit than the detox product."

You'll have heard the claims before - specially designed with this, professionally formulated from that. There are "rare combinations", "unique blends" and even "powerful super foods", all claimed to be the next big thing helping you lose weight fast. But what's really in the detox box?

Of the powders, potions and pills we looked at, most contain a combination of fruit and vegetable extracts, liver tonics, laxatives and traditional weight-loss aids.

Caffeine

Known for its ability to stimulate your central nervous system, caffeine is present in two of these products, most likely because of its ability to speed up your metabolism. It's generally accepted that the caffeine in two to four cups of coffee each day is harmless, however too much caffeine can make you anxious and may cause headaches or abnormal heart rhythms. While the 4321 Slim Evolution gives a precise measure for the amount of caffeine in each dose on its label, its sister product, the 4321 10 Day Body Boot Camp, does not. It's interesting to note that while some products give you added caffeine, others require it to be eliminated for the duration of the detox, which can cause headaches for those who regularly consume coffee.

Green tea

The two 4321 products also contain green tea, considered to have antioxidant properties and the ability to improve mental alertness (most likely because of its caffeine content) and often used as a weight loss aid. But despite this, there is little reliable data to determine whether this age-old beverage will help to cleanse or cut the kilos.

Bitter orange

Also said to speed up metabolism is bitter orange, a key ingredient in the Blackmores Kickstart Detox. Experts say there's not enough evidence to support the use of this ingredient for health purposes, particularly given reports of its links to fainting, heart attack and stroke. Bitter orange should be avoided by people with high blood pressure and should not be taken in conjunction with caffeine, yet the Kickstart Detox's packaging and the public summary of the product in the Australian Register of Therapeutic Goods (ARTG) fail to contain such warnings.

Super berries

Berries such as acai, goji and cranberries also appear in a number of products. Cranberries have known antioxidant properties and can help prevent urinary tract infections, although the evidence is not definitive and caution should be exercised by those who take blood-thinning drugs, such as warfarin and aspirin, in taking a product that contains cranberries. Goji berries should also be avoided by people on warfarin. There is no definitive scientific evidence to support the claims that acai berries, native to Central and South America and promoted widely as a "superfood", promote weight loss.

Extracts

Di Prima says while there's nothing dangerous about most of these ingredients, the whole food is always going to be better than a single extract. As an example, beta-carotene, found in both of the 48-hour detoxes, appears to be associated with an increased risk of lung cancer in smokers when taken as a supplement, but eating a lot of beta carotene-containing fruits and vegetables is associated with a lower risk.

Ingredients to encourage bowel movement

The inclusion of psyllium in the Quick Cleanse and Skinny Mini is designed to promote regular bowel movements. Although not harmful in itself, psyllium should not be taken with the common painkiller aspirin and people with diabetes, heart disease or high blood pressure should be especially cautious - although the product fails to provide this warning on its packaging. Rhubarb and senna are also used in some of the products to promote regular bowel movements. However, if you eat a sufficient amount of high-fibre foods, such as oats, grains and fruits, this should not be an issue for you.

Silybin

Silybin, the biologically active element of milk thistle, appears in the Bioglan Intense Cleanse and the Quick Cleanse. Historically thought to protect and improve liver function, laboratory studies suggest this could be correct, although clinical trials have not been able to link the two.

Taurine

Taurine is thought to contain antioxidants and may improve liver function in patients with existing liver disease (hepatitis), however there's no evidence to support the idea that taurine can improve the function of a healthy liver. The QuickTrim Fast Cleanse (endorsed by Kim and Khloe Kardashian) claims you'll slim down and lose your bloat in just 48 hours - although the fructose and soybean fibre may have exactly the opposite effect on some people, according to McGrice.

Chitosan

Chitosan, a dietary fibre derived from the shell of crustaceans, is popular in weight-loss products for its ability to bind small amounts of fat into waste. As an ingredient in the 4321 10 Day Body Boot Camp, chitosan appeals to those looking to shed excess kilos, although this is not all it is capable of shedding. Chitosan does not distinguish between different types of fat, which means good fats, such as omega-3s, can also be lost in the process. More importantly, good-quality studies suggest the effect of chitosan on body weight is minimal. The US Food and Drug Administration warns directly against the use of chitosan, which it says may cause problems for those allergic to shellfish. McGrice says while chitosan may play a role in weight loss, "there are better things that can be done to improve metabolism, such as exercise".

The expert verdict

Most of the products we looked at came with the recommendation that the detox be undertaken in conjunction with a healthy eating plan. Di Prima says although the ingredients may not always have a scientific benefit, the upside of detox products is the way they encourage consumers to embark on new health regimes.

"[On the detox], people will exercise more, eat better, cut out bad foods and lose weight. They attribute this to the tablet, but it is more likely the change to lifestyle that has made the difference."

The worst detox product

Lemon and sugar is perfect for pancakes, but what about detoxing? Dubbed an extreme and terrible dieting option by our dietitians due to its recommendation you eliminate all food for seven days, the Pure Natural lemon detox costs $87 online (plus the cost of postage and a few lemons). We decided to compare how much people are paying for this product, with the true cost of its ingredients, which likely have no real health benefits whatsoever. To buy similar ingredients from a supermarket - one litre of golden syrup, a packet of cayenne pepper, a 50 pack of senna laxative tablets and jar of sea salt - cost us less than $25 (lemons not included).

The Therapeutic Goods Administration (TGA) is the government body responsible for regulation of medicinal products. Products listed with the TGA are divided into two categories: registered goods (AUST R) and listed goods (AUST L).

All registered medicines, deemed to be of higher risk - such as prescription drugs - are individually assessed for efficacy and safety before they reach the shelf, while listed goods, considered to be of lesser risk, usually reach the shelf without any regulatory examination. Only about 20% of new listings in this category are randomly assessed each year for compliance with TGA requirements.

All the products we looked at are available over the counter in pharmacies, yet some aren't even listed with the TGA. Those products not listed, formulated as liquids or powders, fall within the realm of Food Standards Australia and New Zealand (FSANZ). FSANZ's Health Claims Standard regulates high-level health claims attached to food products, including powder sachets and oral liquids clearly intended to be sold as diet detox products.

When it comes to advertising claims on such detox products, in 2012, Dr Ken Harvey, former adjunct associate professor at La Trobe University's School of Public Health, brought a complaint before the Complaints Resolution Panel of the TGA's Advertising Code Council for misleading claims attached to a detox product. The claims made about Slimright 123 Detox n Burn, that it would detoxify the body, reduce bloating and cleanse toxin build up, were found to be misleading and likely to raise unwarranted expectations. Similar claims are attached to all these products, however only the products listed with the TGA can be regulated under the code.

Our experts say that, in the absence of adequate regulation, it's up to consumers to look out for words used in conjunction with claims on these products, such as "aids" and "assists", effectively buying leeway for the manufacturers.